Application of LDL-apheresis and immunoadsorption in kidney diseases.

Plasmapheresis is one of the methods of extracorporeal blood purification used for many decades for the treatment of different kidney and extrarenal diseases, mainly of autoimmunological nature. The main disadvantage of this method is the lack of selectivity and the risk of infections associated with plasma used for supplementation. Hence, the efforts are made to establish an alternative blood purification treatment that might be used in renal diseases instead of plasmapheresis. These alternative methods should be more selective in certain pathogenic factors elimination and result in less risk for patient, both acute and delayed. Recently two such methods were applied more frequently to everyday nephrological practice, i.e. LDL-apheresis and immunoadsorption. The present paper aims to review the current state of knowledge regarding use of two mentioned methods in kidney diseases. Despite their very high costs both of them if used early in certain, refractory nephropathies may ameliorate their clinical course and significantly improve the prognosis. In addition they may significantly reduce the overall costs of therapy due to avoidance of unnecessary immunosuppression, prolonged hospitalization and finally--costs of postponed renal replacement therapy.